IRIS Health Services is an award-winning health insurance third-party administrator (TPA) providing medical benefit and claims administration services. We are regulated by the Insurance Authority of UAE, Dubai Health Authority and Department of Health, Abu Dhabi; and the Capital Markets Authority of Oman.
IRIS also manages specialized insurance needs for reinsurers, regulators and self-insured companies: for example, we build and maintain provider networks, provide membership and customer care services in addition to claims processing.
Since our 2014 launch, IRIS has grown exponentially: Today we serve more than 400,000 insured members and 40,000 clients in the UAE alone from our corporate headquarters in Dubai and network office in Abu Dhabi. We recently expanded into Oman and work with clients including leading insurance and reinsurance companies in East Asia, the Indian subcontinent and Europe.
What sets us apart:
For us at IRIS, every member and every client matters.
For our risk carriers, we work hard to extend best practices in adjudication by integrating the latest technologies like AI and blockchain with experience and expertise. We help control insurance costs and protect from fraud, waste and abuse. We provide cost-effective solutions while delivering the best possible outcomes for those in their care.
For our insured members, we drive ourselves to provide seamless, direct access to the best possible healthcare and services. We invest in technologies like mobile apps to help and guide our insured members with information at their fingertips. We also invest in their wellbeing with preventive initiatives and on-time advice and support.
We achieve these goals through the strength of our team, by championing innovation, and by being invested in the health of our community.
Our team is made up of more than 90 professionals who bring a wealth of experience and expertise and share our ‘You Matter’ ethos. These specialists provide an individual, optimal approach for each client and member, allowing us to manage our clients’ resources and our members’ health carefully and responsibly.
Our 24-hour, multilingual call centre and in-house team of doctors, for example, are among those who help us deliver on these goals.
Our innovation is most evident in two key areas: Our proprietary, cutting-edge software platform Ezyclaim and our purpose-built, customizable mobile app.
The Ezyclaim online knowledge management suite is a game-changer in health insurance claims circles. It gives our clients the ability to monitor usage in real-time, detect trends, monitor for fraud, review performance and manage their portfolios with unparalleled efficiency and transparency.
Why trust us
We are ISO 9001:2008 certified, our quality policy is “Quality through operational excellence, teamwork and efficiency.” We are ISO 27001:2013 certified, conforming to the highest standards of information security, data security and patient health information confidentiality. Our commitment to social responsibility also means we are ISO 26000 compliant.
IRIS chose to pursue the Committee on Operating Rules for Information Exchange (CORE®) PHASE I, II, III & IV Endorser Seal, an American standard that sets the bar for patient confidentiality and data security. We are the only company in the GCC region to maintain the CORE standard.
Clients, members and the industry have recognized IRIS’ work and practices. Our accolades include the ‘Innovation of the Year’ award at the Etisalat SMB Awards 2019, ‘Most Innovative Service Provider’ at the MENA Insurance Review Awards 2018 and ‘Most Innovative Insurance Claims Software 2018’ from International Finance magazine.
Our third-party and audit services are trusted by prestigious clients including Oman Insurance Company, RAK Insurance Company, Abu Dhabi National Insurance Company, Al Fujairah Insurance Company, Dubai Islamic Insurance & Reinsurance Company (AMAN) and Union Insurance Company.
IRIS’ sister companies in India and Singapore service more than 600,000 members in complex and fast-changing markets. Our group capacity helps us improve how we process claims, develop products, manage portfolios and protect our clients and partners against fraud, waste and abuse.
Our service offerings go beyond administrative support for healthcare products to span health insurance product design, medical risk evaluation, medical management, medical service provider panel (network) management, training and consulting services.
IRIS Health Services works to provide the best outcomes for our insured members, clients, partners and communities with the expertise of our team, tradition of innovation and commitment to health and wellbeing.
To be the preferred Claims Management partner across geographies.
Our Claim Philosophy
To use technology and knowledge wisely and carefully to provide efficient and considered claims management services that benefit all our stakeholders
Our Success Factors
- Experience and skill in building and sustaining strong, mutually beneficial relationships with providers
- Offering reliable services to healthcare providers
- Effective negotiations with major hospitals, clinics, pharmacies and laboratories.
- Providing quality and reliable services to customers, especially with our local and multilingual 24/7 Call Centre, rapid response time and consistency in administration
- Specialists in all matters of health insurance management including policy administration services, claims handling and processing, portfolio analysis, trend analysis, claims auditing, fraud and abuse detection and handling.
- The IRIS management team represents an aggregation of more than 100 years of experience in Health Insurance, TPA services, financial services and management. Our corporate diversity – IRIS staff represent different nationalities from across Asia, Africa and the Middle East – and inclusiveness also means we are able to work with and assist in any kind of environment.
- In every sphere of our operations, IRIS is committed to improving how we work and how our industry operates by using technology to improve the quality, availability and responsiveness of care and to maximize the resource efficiency of the healthcare ecosystem. We develop intuitive, accessible, scalable and secure solutions that work for regulators and individual policyholders alike, and train those who need to know how best to use them. We champion communication, participation and organization in the service of a better integrated and beneficial system for all.